“I Do Feel Like a Scientist at Times”: A Qualitative Study of the Acceptability of Molecular Point-Of-Care Testing for Chlamydia and Gonorrhoea to Primary Care Professionals in a Remote High STI Burden Setting

Background

Point-of-care tests for chlamydia (CT) and gonorrhoea (NG) could increase the uptake and timeliness of testing and treatment, contribute to improved disease control and reduce reproductive morbidity. The GeneXpert (Xpert CT/NG assay), suited to use at the point-of-care, is being used in the TTANGO randomised controlled trial (RCT) in 12 remote Australian health services with a high burden of sexually transmissible infections (STIs). This represents the first ever routine use of a molecular point-of-care diagnostic for STIs in primary care. The purpose of this study was to explore the acceptability of the GeneXpert to primary care staff in remote Australia.

Methods

In-depth qualitative interviews were conducted with 16 staff (registered or enrolled nurses and Aboriginal Health Workers/Practitioners) trained and experienced with GeneXpert testing. Interviews were digitally-recorded and transcribed verbatim prior to content analysis.

Results

Most participants displayed positive attitudes, indicating the test was both easy to use and useful in their clinical context. Participants indicated that point-of-care testing had improved management of STIs, resulting in more timely and targeted treatment, earlier commencement of partner notification, and reduced follow up efforts associated with client recall. Staff expressed confidence in point-of-care test results and treating patients on this basis, and reported greater job satisfaction. While point-of-care testing did not negatively impact on client flow, several found the manual documentation processes time consuming, suggesting that improved electronic connectivity and test result transfer between the GeneXpert and patient management systems could overcome this. Managing positive test results in a shorter time frame was challenging for some but most found it satisfying to complete episodes of care more quickly.

Conclusions

In the context of a RCT, health professionals working in remote primary care in Australia found the GeneXpert highly acceptable. These findings have implications for use in other primary care settings around the world.

Below:  Influences on acceptability of Xpert CT/NG to operators in remote health services

Full article at:   http://goo.gl/FUoJLa

By:   

Lisa Natoli, Rebecca J. Guy, Louise Causer, Steven G. Badman, John Kaldor, Lisa Maher

The Kirby Institute, UNSW Australia, Sydney, NSW, Australia

Lisa Natoli, David Anderson

The Burnet Institute, Melbourne, VIC, Australia

Mark Shephard

Flinders University International Centre for Point of-Care Testing, Flinders University, Adelaide, SA, Australia

Belinda Hengel

Apunipima Cape York Health Council, Cairns, QLD, Australia

Annie Tangey

Ngaanyatjarra Health Service, Alice Springs, NT, Australia

James Ward

South Australian Health and Medical Research Institute, Adelaide, SA, Australia

Tony Coburn

Queensland Aboriginal and Islander Health Council, Brisbane, QLD, Australia

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